Pregnancy isn’t the most comfortable time of a woman’s life. I’m halfway through mine, and have already experienced plenty of headaches, stabbing pains and cramps.
So it is worrying that research is continually finding that mild painkillers, such as paracetamol and ibuprofen, could pose risks to developing fetuses. The latest study suggests that ibuprofen seems to pass through the placenta with ease, and wreaks irreversible damage on a female fetus’s developing ovaries.
A girl is born with all the eggs she will ever have, according to prevailing wisdom, so any impact on her egg reserve will last a lifetime, potentially affecting her future fertility and the age at which she experiences menopause.
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The study tested the effects of ibuprofen on ovarian tissue from aborted fetuses, so it is far from an exact replica of real pregnancy. But it’s not the only research pointing out the danger of everyday painkillers.
It is already well known that ibuprofen can interfere with a fetus’s blood supply during the late stages of pregnancy, and has been linked to miscarriage in early pregnancy. As a result, doctors recommend that pregnant women avoid taking ibuprofen.
Painkiller of choice
But how many pregnant women know this? The drug is cheaply, easily available and many people probably think little of taking a tablet or two for mild pains. A of new mothers in the US and Canada found that around 28 per cent had taken ibuprofen at some point in their pregnancy.
Perhaps more concerning is paracetamol (or acetaminophen). This medicine is actively recommended as the painkiller of choice in pregnancy, and more than half of women in Europe and the US take it while pregnant. But we are still only beginning to learn what, if anything, it might do to a developing fetus.
While there is no conclusive evidence that paracetamol use in pregnancy causes birth defects – or any other lasting condition – it has been associated with altered brain development in fetuses. Studies have linked it to and increased chance of Ěý˛ą˛Ô»ĺ .
When my doctor recently recommended paracetamol for my own headaches, I told him I had read these studies, and asked how worried I should be. “I’ve read those studies too,” he told me. “But they haven’t changed the guidelines – yet.” Not particularly reassuring words.
But why are we only now working out if these household drugs might put fetuses at risk? Part of the problem is that drugs are not routinely tested on pregnant women, as experimenting on fetuses would be unethical.
Weighing up the risks
The general advice is for pregnant woman to avoid drugs if they can, and the effects of any medicines used should be monitored over time. The problem is that this doesn’t tend to happen for the painkillers anyone can buy from their local supermarket.
None of the researchers I spoke to felt that there was enough evidence to change the current guidelines – which recommend paracetamol but advise against ibuprofen. Pregnant women shouldn’t experience pain or fever without treatment. In fact, fever could even bring on premature labour. Being born too early is associated with much greater risks than those associated with paracetamol use.
But they did express the hope that pregnant women be advised to take the smallest dose of paracetamol they need for the shortest period of time, and not use it if just feeling tired or run down. “People often forget that it’s a powerful drug,” says , who studies the effects of paracetamol at the University of Bristol, UK.
Of course, it’s always best to check with a doctor before taking any treatment while pregnant. And while I’ve packed away my own paracetamol stash for now, I’m bearing in mind that it still appears to be the safest option for treating pain and fever in pregnancy.
Read more: What’s wrong with the world’s favourite painkiller?
Human Reproduction
